不同材料栓塞甲状腺动脉治疗甲状腺功能亢进症的疗效分析  

Efficacy analysis of thyroidal arterial embolization in treating hyperthyroidism with different embolizing materials

作　　者：杨继金[1] 林琳[1] 田建明[1] 叶华[1] 张火俊[1] 毕永民[1] 邹大进[1] 陈炜[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433

出　　处：《介入放射学杂志》2003年第2期88-90,共3页Journal of Interventional Radiology

摘　　要：目的　研究不同材料栓塞甲状腺动脉治疗甲状腺功能亢进症 (甲亢 )的疗效。方法　 5 6例甲亢患者分为两组 ,A组 2 5例 ,采用平阳 (博莱 )霉素 2 4mg动脉灌注后以明胶海绵、不锈钢圈栓塞。B组 31例采用聚乙烯醇 (PVA)颗粒栓塞 ,2例同时加用少量明胶海绵颗粒。对两组病例的疗效及常见并发症进行比较 ,并对复发病例的动脉栓塞数与复发率的关系进行分析。结果　两组病例近期疗效均达10 0 % ,随访中A、B两组复发率分别为 2 8%和 16 .1% ,但差异无显著性。栓塞 2支动脉者复发率为4 6 .7% ,栓塞 3、4支动脉者总复发率为 12 .2 % ,差异有显著性 (χ2 =7.75 1,P <0 .0 1)。B组常见并发症明显较A组高 ,但无需特殊处理。结论　甲状腺动脉栓塞术治疗甲亢损伤小、疗效好 ,栓塞动脉数要达 3支以上 ,否则复发率高。PVA颗粒使用方便 。Objective To study the efficacy of thyroidal arterial embolization in treating hyperthyroidism by using different embolizing materials and the relationship between recurrence rate and the numbers of embolized arteries. Methods 56 cases with hyperthyroidism were divided into group A (25 cases) and group B (31 cases). Patients of group A had their thyroidal arteries embolized with gelfoam particles and stainless coils after arterial infusion of a total dosage of 24 mg of blemycin. Patients of group B had their thyroidal arteries occluded with polyvinyl alcohol (PVA) particles. The effectiveness and general complications of arterial embolization for these two groups were compared and the relationship between recurrence rate of hyperthyroidism after treatment and numbers of embolized thyroidal arteries was studied. Results It showed effectiveness in all patients within 2 3 months. The follow up records showed, the recurrence rate of hyperthyroidism was 28% and 16.1% for group A and group B respectively but without statistical difference. The recurrence rates were 46.7% for those patients with 2 thyroid arteries embolized and 12.2% for those with 3 4 arteries embolized, showing significant difference ( χ 2=7.751, P <0.01). General complications for group A were much more than those for group B. Conclusions Thyroidal arterial embolization is minimally invasive and highly effective in treating hyperthyroidism. With better results obtained by more than three thyroid arteries be embolized, PVA particles are easy to be used and perhaps more effective in occluding thyroidal arteries.

关 键 词：甲状腺动脉 甲状腺功能亢进症 临床疗效 动脉栓塞 介入治疗 聚乙烯醇 明胶海绵颗粒 

分 类 号：R581.1[医药卫生—内分泌] R815[医药卫生—内科学]